These procedures are designed for patients who have failed conservative non-surgical options. Typically, they are performed in conjunction with a palatal procedure or a hyoid procedure, or both.

 

Over the years, researchers have discovered that in cases where a UPPP fails, the tongue is the main culprit. Once the tongue collapse is addressed as well, the "success" rate increases to ~75%. Many subsequent studies report success rates in the 70-80% range.

 

There are many ways of addressing tongue collapse. At Stanford, they perform (in addition to the UPPP) a mandibular osteotomy with genioglossus advancement (MOGA), and hyoid myotomy with suspension (HMS). MOGA involves advancing the portion of your tongue that attaches to the midline lower jaw, and HMS involves pulling the hyoid bone, which is a c-shaped bone on top of your voicebox that attaches to your tongue and voicebox. Of the 25% that fail this operation, a portion went on to more definitive surgery, called a maxillo-mandibular advancement. This is a complex and long procedure that literally pulls the middle of your face and jaw bones forward. As expected, this procedure is well more than 90% effective.

 

 

Another way of treating tongue collapse is radiofrequency volumetric tissue reduction. A thin needle is placed in the tongue base and radiofrequency energy is given to shrink the tissues. In essence, it is causing a small controlled burn, which causes scarring and tightness as it heals over weeks. It must be performed 4-5 times, on a monthly basis. Typically, the first procedure is performed in the operating room, along with other procedures (such as the UPPP or hyoid suspension), and the subsequent session are performed in the office.